Paper Information

Bacterial meningitis remains a recurrent public health threat in the African meningitis belt despite vaccination efforts. Following the introduction of the Meningococcal Africa vaccine, shifts in causative pathogens have been observed. In early 2025, a meningitis outbreak occurred in Ghana´s Upper West Region, necessitating a detailed epidemiological and response assessment. We conducted a retrospective descriptive cross-sectional analysis of surveillance data from all 11 districts of the Upper West Region, Ghana. Records of suspected meningitis cases reported between epidemiological weeks 1 and 15 of 2025 were reviewed. Data were obtained from regional line lists, case-based investigation forms, laboratory reports, and weekly situational updates. Variables analysed included age, sex, district, laboratory confirmation, bacterial aetiology, case fatality rate, and outbreak response activities. A total of 228 suspected meningitis cases and 17 deaths were reported, yielding an overall case fatality rate of 7.7%. Thirty-six cases (15.8%) were laboratory-confirmed, with Streptococcus pneumoniae accounting for 86.1% of confirmed infections, followed by Neisseria meningitidis (5.6%) and Haemophilus influenzae (5.6%). Adolescents and young adults aged 10-29 years were most affected, with a slight male predominance. The outbreak peaked during epidemiological weeks 7-8, with spatial clustering in the Wa Municipal, Nadowli-Kaleo, and Nandom districts. Public health response measures included activating rapid response teams, intensifying surveillance through the surveillance outbreak response management and analysis system and retraining over 250 health workers. Key challenges identified were limited laboratory capacity, inadequate diagnostic tools, and insufficient sustainable funding. The 2025 meningitis outbreak in Ghana´s Upper West Region demonstrates a clear shift towards pneumococcal predominance within the meningitis belt. While coordinated multisectoral response efforts successfully curtailed transmission, persistent gaps in diagnostic capacity, human resources, and sustainable financing threaten future preparedness. Strengthening subnational laboratory systems, expanding multivalent vaccination strategies, and securing predictable outbreak-response funding are critical to achieving the World Health Organization´s defeating meningitis by 2030.